Epidural and intrathecal analgesia in a rural setting.

Epidural anesthesia--alone or in combination with general anesthetic agents--is beneficial to physiological and cardiovascular stability during surgery. The placement of an epidural catheter at the time of surgery also provides access for the administration of epidural narcotics for postoperative analgesia. This article describes how a rural acute care facility initiated a program of epidural analgesia administered by the nursing staff under the direction of the anesthesia department utilizing AANA protocol.* In such a setting, an educated nursing staff can serve as an extension of the anesthetist in overseeing patient response to epidural and intrathecal narcotics.